The community based rehabilitation program

The Community Based Rehabilitation program in UPMRC is considered one of the leading rehabilitation programs in the country. The program aims foremost at achieving full social integration of disabled persons into their own communities by maximum utilization of existing community resources. The concept is based on providing opportunities for disabled people at equal footing with other community members. The rehabilitation program was established in the late eighties as one of the major activities within UPMRC strategy to provide essential health services to the poor and marginalized in Palestine. It further developed utilizing UPMRC's experience in community mobilization and organization as well as the widespread network of its PHC centers. Currently the program is working in 87 localities with a total coverage of 320,000 population. Preschool and school-aged children have been especially successful at experiencing social integration.

The cornerstone of the CBR program is home-based training. Our workers train the disabled person and his or her family in methods that will maximize the patient's mobility and independence. We have also opened community resource centers for disabled children. These centers enable disabled children and their parents to meet and share problems with others in similar situations. Hand-in-hand with these services are hundreds of awareness-raising projects and events that include the broader community.

One of the most important tasks of the program is to integrate disabled children into schools and kindergartens. Program activities in this area involve not only the disabled children, but also the other children and teachers in the target schools. Hundreds of education and promotion sessions were held with school children and teachers aimed at affecting positive change in attitudes, thus facilitating integration process. In 1999, more than 200 disabled children were integrated into normal schools and kindergartens (a 76% increase from 1998), bringing the number of disabled children who have been integrated into the mainstream educational facilities to 823.

In cooperation with the schools and kindergartens, the program organized 19 summer camps that included more than 400 disabled children. In 1999, all summer camps were run by volunteers from the local communities, most of them were women. The program also works closely with adults, assisting in their integration into the workforce. Through vocational training and job placement, 71 disabled persons have been integrated into mainstream jobs.

Community Work

Our marches and lobbying efforts raise consciousness about the challenges facing disabled people. It has been our experience that disabled children, especially girls, are particularly at risk for neglect and discrimination. Consciousness-raising efforts are important in securing fair treatment and equal rights for all people with disabilities. Between 2 and 3 percent of the Palestinian population is disabled.

The community work also makes people aware of ways to make the community more accessible to disabled people. We encourage communities to use existing local resources to make simple aids and home and community adaptations. Furthermore, we train local rehabilitation workers so that the program can eventually be totally managed by people from the area.

Through greater emphasis on community mobilization, the program organized more than 3,326 community activities during 1999. The total number of volunteers who were actively involved in program activities is estimated to be 1,797. In addition to their help with the community activities, volunteers and local community structures also aided in cost sharing technical aides needed. A total of 200 technical aid equipment were provided for disabled persons in need.

Prevention and Early Intervention

We conduct prevention and early detection activities in cooperation with hundreds of volunteers, various institutions and other components of the UPMRC Primary Health Care system. Treatment and referrals are also carried out in cooperation with many different institutions. The presence of trained CBR team members in extensive areas has played an important role in the proper referral of cases.

The core elements of the CBR program-therapy, community involvement, and prevention and early intervention-make the program a powerful agent of change in each community where it is carried out. As such, it is unique within the framework of rehabilitation in Palestine. The program has also been significant in establishing a well-coordinated regional and national referral system for the treatment of disabled people.

At the regional level the program was able to improve the existing referral system by organizing a regional workshop including government and NGO institutions to discuss this matter. Coordination committees have been established in five regions, with representatives of different ministries as well as representatives of the NGOs and the representatives of the disabled persons themselves participating in these committees. During 1999, the program conducted 1,267 referrals at different levels - 50% at the regional level, 40% at the local level, and 10% at the national level.

One of the most important events of 1999 was the adoption of the Palestinian disabled law by the Palestinian Legislative Council (PLC). UPMRC's CBR program, in conjunction with the PNGO Network, played a very important role in this process. In cooperation with the General Union of Palestinian Disabled and the Central National Committee for Rehabilitation, a massive campaign was aimed at lobbying the PLC to adopt a law that guarantees the rights of disabled persons. The NGO sector, the disabled, and their representatives played a decisive role in shaping the law in its final form.

During 1999, special attention was given to inservice training and quality improvement. An inservice training program has been designed to address the needs of rehabilitation workers, and several training activities (courses, workshops, training sessions) were organized in cooperation with the School of Community Health and other relevant institutions. Each rehabilitation worker averaged 14 training days during the year.

UPMRC holds a key position within the Executive Committee of the Central National Committee of Rehabilitation in Palestine, the highest central coordinating and policy making body dealing with disabled persons. We value this organization and have, since its establishment in 1989, maintained a high level of participation in its coordination and strategic planning efforts. We hope our CBR program will serve as a model for a national program.

Areas of Coverage: Nablus, Jenin, Ramallah, Tulkarem, Qalqilya, Jericho, the Jordan Valley, and the Gaza Strip.